Achilles tendon

SINGLE LEG LANDING STRATEGY IS ALTERED IN MALE PROFESSIONAL RUGBY UNION PLAYERS WHO DEVELOP ACHILLES TENDINOPATHY COMPARED TO INJURY FREE CONTROLS

Analysis of lower limb biomechanics during jumping and landing tasks are often used to assess lower limb injury risk in research and applied practice within professional team sports. However, there are limited instances of these movements being incorporated into research focusing on Achilles tendinopathy development. PURPOSE: To investigate whether differences existed in lower limb motion and moments during jumping and landing between individuals who develop Achilles tendinopathy and those who remain injury free. METHODS: Male professional Rugby Union players without lower limb injury (n = 43) were compared to players who sustained Achilles tendinopathy (n = 8). Five single-leg drop vertical jumps per leg were performed at the start of their pre-season training. Motion of the lower limbs were recorded synchronously with ground reaction force. RESULTS: Players who sustained Achilles tendinopathy demonstrated significantly increased rear-foot inversion-eversion range of motion (p = 0.03), a reduction in dorsi-plantarflexion range of motion (p = 0.01) and knee flexion-extension range of motion (p = 0.03). Peak dorsiflexion velocity (p = 0.02) and peak knee flexion velocity were also reduced in those with Achilles tendinopathy (p = 0.03). No differences in hip joint kinematics were observed. Controls displayed slightly larger peak plantarflexion moments; however this difference was not statistically significant (p = 0.15, g = 0.60). CONCLUSIONS: The findings indicated that players who subsequently developed Achilles tendinopathy displayed an altered single leg landing strategy when compared to players who did not sustain injury; with motion of the ankle joint and rear-foot most influenced.


Listed In: Biomechanics, Sports Science


IN VIVO ACHILLES TENDON FORCES DURING CYCLING DERIVED FROM 3D ULTRASOUND-BASED MEASURES OF TENDON STRAIN

Introduction and Objectives: Traditional motion analysis provides limited insight into muscle and tendon forces during movement. This study used B-mode ultrasound, in combination with measured joint angles and scaled musculoskeletal models, to provide subject-specific estimates of in vivo Achilles tendon (AT) force. Previous studies have used ultrasound images, tracked in 3D space, to estimate AT strains during walking, running, and jumping [1,2]. Our approach extends this work in one novel way. Specifically, we characterized AT stiffness on a subject-specific basis by recording subjects’ ankle moments and AT strains during a series of isometric tests. We then used these data to estimate AT force during movement from in vivo measurements of tendon strain. To demonstrate this approach, we report AT forces measured during cycling. Cycling offers a unique paradigm for studying AT mechanics. First, because the crank trajectory is constrained, joint angles and muscle-tendon unit (MTU) lengths of the gastrocnemius (MG, LG) and soleus (SOL) are also constrained. By varying crank load, subjects’ ankle moments can be altered without imposing changes in MTU lengths. For this study, 10 competitive cyclists were tested at 4 different crank loads while pedaling at 80 rpm. Based on published EMG recordings (e.g., [3]) and on in vivo tendon force buckle data from one subject [4], we hypothesized that the cyclists’ AT forces would increase systematically with crank load. Methods: We coupled B-mode ultrasound with motion capture, EMG, and pedal forces to estimate in vivo AT forces non-invasively during cycling and during a series of isometric ankle plantarflexion tests. Marker trajectories were tracked using an optical motion capture system. Joint angles and MTU lengths were calculated based on scaled musculoskeletal models [5] using OpenSim [6]. A 50 mm linear-array B-mode ultrasound probe was secured over the distal muscle-tendon junction (MTJ) of the MG and was tracked using rigid-body clusters of LEDs. AT lengths were calculated as the distance from a calcaneus marker to the 3D coordinates of the MG MTJ. Subject-specific AT force-strain curves were obtained from isometric tests using ultrasound to track the MTJ, markers to track both the ultrasound probe and the AT insertion, and a strain gauge to measure the net ankle torques generated by each of the subjects at ankle angles of -10° dorsiflexion, 0°, +10° plantarflexion, and +20° plantarflexion. AT strain during cycling was converted to AT force using each subject’s force-strain relation. Subject-specific tendon slack lengths were calculated as the mean tendon length at 310° over all pedal cycles, based on examination of the AT length changes and on published data showing that this position in the pedal cycle precedes tendon loading across multiple pedalling conditions [4]. Results: Peak AT forces during cycling ranged from 1320 to 2160 N ± 400 N (mean± SD) and increased systematically with load (p<0.001; Fig. 1A/B). At the highest load, the peak AT forces represented, on average, 50 to 70 % of the combined MG, LG, and SOL muscles’ maximum isometric force-generating capacity, as estimated from the muscles’ scaled volumes [7], the muscles’ scaled optimal fiber lengths [5], and a specific tension of 20-30 N/cm2. Peak AT forces occurred midway through the pedaling downstroke, at about 80°, which is consistent with the AT forces directly measured from one subject [4] and with patterns of EMG during cycling [3]. Peak AT strains during cycling were uncoupled from the MG MTU strains and ranged from 3 to 5 % across the different loads examined, measured at the MG MTJ. Conclusion: Our results are consistent with published data from a single subject in which AT force was measured using an implanted tendon buckle [8]; however, our results were obtained non-invasively using ultrasound and motion capture. These methods substantially augment the experimental tools available to study muscle-tendon dynamics during movement. References: [1]Lichtwark and Wilson, 2005, J Exp Biol, 208(24), 4715-4725. [2]Lichtwark et al., 2007, J Biomech, 40(1), 157-164. [3]Wakeling and Horn, 2009, J Neurophysiol, 101(2), 843-854. [4]Gregor et al., 1987, Int J Sports Med, 8(S1), S9-S14. [5]Arnold et al., 2010, Ann Biomed Eng, 38(2), 269-279. [6]Delp et al., 2007, IEEE Trans Bio Med Eng, 54(11), 1940-50. [7]Handsfield et al., 2014, J Biomech, 47(3),631-638. [8]Gregor et al. 1991, J Biomech, 24(5), 287-297
Listed In: Biomechanics, Sports Science


EFFECT OF EXERCISE-INDUCED CHANGES OF THE INTRINSIC TRICEPS SURAE MUSCLE-TENDON UNIT PROPERTIES ON MAXIMAL WALKING VELOCITY IN THE ELDERLY

Introduction and Objectives: It has previously been reported that deterioration in contractile strength and tendon stiffness in the elderly is associated with altered motor task execution and reduced performance while walking [1,2], and that resistance training improves muscle function, resulting in more effective and safer gait characteristics in the older population [3]. In particular, triceps surae (TS) muscle-tendon unit (MTU) properties seem to be an important determinant for walk-to-run transition speed [4], emphasizing the relevant role intrinsic MTU properties play in gait performance. The objective of this empirical study was to examine the hypothesis that maximal walking velocity is related to TS MTU mechanical and morphological properties and their enhanced capacities would improve gait velocity in the elderly. Methods: Thirty four older female adults (66±7 yrs.) took part in the study. Nineteen of them were recruited for the experimental group, who underwent a 14-week TS MTU physical exercise intervention which has been previously established to increase muscle strength and tendon stiffness [5]. The remaining 15 subjects formed the control group (no physical exercise intervention). The experimental group performed three times per week five sets of four repetitive (3·s loading, 3·s relaxation) isometric plantar flexion contractions in order to induce high cyclic strain magnitudes on the TS tendon and aponeurosis. Maximal walking velocity, defined as walking with a double support phase, was determined by using two force plates (60 x 40 cm, 1080 Hz; Kistler, Winterthur, CH) and a motion capture system (Vicon Motion Systems, Oxford, UK) with 12 infrared cameras operating at a frequency of 120 Hz. TS MTU properties were assessed using simultaneous dynamometry and ultrasonography (Esaote MyLab Five; Esaote Biomedica, Genoa, IT). Results: A significant correlation was found between the TS MTU mechanical and morphological properties and maximal gait velocity (0.40 < r < 0.64; P < 0.05; n = 34). The experimental group showed higher TS contractile strength, tendon stiffness, and higher gastrocnemius medialis muscle thickness post- compared to pre-intervention (P < 0.05). However, calculated maximal gait velocity did not differ between pre and post-intervention measurements (2.39 ± 0.41 vs. 2.44 ± 0.45 m·s-1). Control subjects showed no statistically significant differences in maximal gait velocity or TS MTU mechanical and morphological properties. Conclusion: This empirical study confirms previous forward simulation models [4] proposing that intrinsic TS MTU properties are significant determinants of gait performance. However, older adults may not be capable of fully utilizing improvements of the MTU capacities while walking at maximal velocities following a 14 week physical exercise intervention. Therefore, the benefits of a long term physical exercise intervention (1.5 years) will be discussed.
Listed In: Biomechanics, Gait, Other


Sensory contributions to standing balance in unilateral vestibulopathy

Patients with unilateral peripheral vestibular disorder (UPVD) have diminished postural stability and therefore the aim of this study was to examine the contribution of multiple sensory systems to postural control in UPVD. Seventeen adults with UPVD and 17 healthy controls participated in this study. Centre of pressure (COP) trajectories were assessed using a force plate during six standing tasks: Forwards and backwards leaning, and standing with and without Achilles tendon vibration, each with eyes open and eyes closed. Postural stability was evaluated over 30s by means of: total COP excursion distance (COPPath) and the distances between the most anterior and posterior points of the COPPath and the anterior and posterior anatomical boundaries of the base of support (COPAmin and COPPmin). In addition, the corrected COPAmin and COPPmin was assessed by taking the corrected base of support boundaries into account using the anterior and posterior COP data from the leaning tasks. UPVD patients showed a tendency for smaller limits of stability during the leaning tasks in both directions. Subject group and task condition effects were found (P<0.05) for COPPath, (i.e. higher values for patients compared to controls). UPVD patients showed lower (P<0.05) COPPmin values compared to the control group for all conditions (more pronounced with the corrected COPPmin). Disturbance of the visual system alone lead to a distinct postural backward sway in both subject groups which became significantly more pronounced in combination with Achilles tendon vibration. The individual limits of stability should be considered in future research when conducting posturographic measurements.
Listed In: Biomechanics, Neuroscience, Physical Therapy, Posturography